Provider Demographics
NPI:1699203067
Name:ROBINSON, IMANI
Entity type:Individual
Prefix:
First Name:IMANI
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IMANI
Other - Middle Name:
Other - Last Name:MCFARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10390 JEFFERSON HWY APT 125
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-7241
Mailing Address - Country:US
Mailing Address - Phone:773-678-8940
Mailing Address - Fax:
Practice Address - Street 1:12097 OLD HAMMOND HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8679
Practice Address - Country:US
Practice Address - Phone:225-246-8816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health